How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,344.23 | Facility | None | $1,412.54 | $1,412.54 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $489.78 | Professional | None | $354.81 | $467.74 | $489.78 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $741.31 Typical High $2,290.87 | Facility | None | $602.56 | $741.31 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $741.31 Typical High $1,412.54 | Professional | None | $407.38 | $741.31 | $1,412.54 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $4,570.88 | Facility | None | $151.36 | $436.52 | $4,570.88 |
United Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $933.25 | Professional | None | $295.12 | $478.63 | $933.25 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $177.83 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $70.79 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $263.03 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $53.70 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $41.69 Typical High $48.98 | Professional | 56 · Pre-op care only | $35.48 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $245.47 | $295.12 | $346.74 |
Where West Virginia sits
The same service costs 4.8 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
West Virginia· 30th of 51
$550
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.